Healthcare Provider Details

I. General information

NPI: 1376515023
Provider Name (Legal Business Name): STEVEN Y CHANG MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BERGEN ST # UH I-354 UMDNJ - MICU DIRECTOR
NEWARK NJ
07103-2496
US

IV. Provider business mailing address

10833 LE CONTE AVE RM 37-131 PULMONARY & CRITICAL CARE MEDICINE
LOS ANGELES CA
90095-1690
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-6111
  • Fax: 973-972-6228
Mailing address:
  • Phone: 310-825-5316
  • Fax: 310-206-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA08089400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA08089400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG89398
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG89398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: